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Published on: December 10, 2013
Clinical predictors of respiratory syncytial virus infection in children
Yamini Durani1, Marla J Friedman, Magdy W Attia
1Division of Emergency Medicine, Department of Pediatrics, Alfred I. duPont Hospital for Children, Thomas Jefferson University, Wilmington, Delaware, USA. ydurani@nemours.org
Insights
A clinical prediction model using cough, wheezing, and retractions can identify respiratory syncytial virus (RSV) infection in young children. This model aids in diagnosing RSV in infants and toddlers presenting with respiratory illness.
Area of Science:
- Pediatrics
- Infectious Diseases
- Clinical Epidemiology
Background:
- Respiratory syncytial virus (RSV) is a common cause of respiratory illness in infants and young children.
- Accurate and timely diagnosis of RSV is crucial for appropriate patient management and public health surveillance.
- Existing diagnostic methods may have limitations in certain clinical settings.
Purpose of the Study:
- To develop and validate a clinical prediction model for identifying RSV infection in pediatric patients.
- To identify key clinical indicators that are independently predictive of RSV infection.
- To provide a tool for healthcare providers to aid in the diagnosis of RSV.
Main Methods:
- A prospective cohort study was conducted with children aged 36 months or younger presenting with respiratory illness.
- Patients suspected of RSV infection underwent diagnostic testing.
- Logistic regression analysis was used to identify independent predictors of RSV infection.
Main Results:
- The study included 197 children, with 64% testing positive for RSV.
- Cough, wheezing, and retractions were identified as significant independent predictors of RSV infection (p < 0.001).
- The developed prediction model demonstrated a sensitivity of 80% and a specificity of 68% for RSV detection.
Conclusions:
- The combination of cough, wheezing, and retractions effectively predicts RSV infection in infants and young children.
- This clinical prediction model can assist in the early identification of RSV in pediatric populations.
- Further validation of the model in diverse clinical settings is warranted.
Aim:
The aim of this study was to develop a clinical prediction model that identifies respiratory syncytial virus (RSV) infection in infants and young children.
Methods:
Children < or = 36 months of age with respiratory illness, who were suspected of having RSV infection, were enrolled in this prospective cohort study during the study period between January and February 2002. RSV testing was performed on all patients.
Results:
Of the 197 patients enrolled in the study, 126 (64%) were positive for RSV and 71 (36%) patients were either negative for RSV or had a positive culture for viruses other than RSV. The mean age of patients was 5 months and 57% were male. Backwards stepwise logistic regression analysis identified cough (p = 0.000), wheezing (p = 0.002), and retractions (p = 0.008) as independent variables predictive of RSV infection. The prediction model had a sensitivity of 80% (95% CI, 71-87%), specificity of 68% (95% CI, 54-79%), positive predictive value 82% (95% CI, 74-89%), negative predictive value 66% (95% CI, 52-77), positive likelihood ratio 2.5 (95% CI, 1.8-3.7) and post-test probability of 82%.
Conclusion:
The combination of cough, wheezing and retractions predicts RSV infection in infants and young children.
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